ACTIVATED PROTEIN-C RESISTANCE, THROMBOPHILIA, AND INFLAMMATORY BOWEL-DISEASE

Thromboembolic events frequently complicate the clinical course of pat ients with inflammatory bowel disease (IBD). Hereditary thrombophilia may contribute to this tendency. Resistance to activated protein C is the most recently described thrombophilic state and may account for up to 40% of patients with thrombophilia. Thirty-seven patients with IBD were studied (mean age 44 years, range 18-82 years). Three patients h ad a history of thrombotic episodes, The 37 controls included 23 men a nd 17 women (mean age 48 years, range 16-89 years). Disease activity w as assessed using the Harvey Bradshaw index for patients with Crohn's disease and the Truelove and Witts grading system for patients with ul cerative colitis. Levels of fibrinogen, antithrombin III (ATIII), prot ein C, protein S, activated protein C resistance (APCR), and the prese nce of a lupus anticoagulant (LA) were determined. Median ATIII levels in patients with IBD were significantly lower than controls (98% vs 1 06%, P = 0.007), while fibrinogen was elevated (4.2 vs 3.3 g/liter, P = 0.026) despite quiescent disease activity. LA was detected in 7/37 p atients in the IBD group compared to 0/37 controls. (chi(2) = 5.68, P = 0.017). NO Significant difference was observed in levels of inherite d thrombophilic factors and in particular APCR between IBD patients an d controls. In conclusion, the presence of inherited thrombophilic def ects, in particular APCR, is uncommon in patients with PBD and does no t merit routine screening.